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Diabetes Forecast

The Healthy Living Magazine

A Quick Guide to Incretin-based Medicines

By Erika Gebel, PhD ,

Two if the newest classes of diabetes medications--incretin mimetics and DPP-4 inhibitors--both work using the same natural process: the incretin system. Incretins are hormones that, after a meal, tell your pancreas to release insulin, which brings blood glucose levels down. Here is a list of available incretin-based medications, plus a few that are still in the pipeline. To read more about these diabetes meds, click here.

Incretin Mimetics

Exenatide (Byetta)
Status: available by prescription
Dosing: injected twice daily within an hour before morning and evening meals
Benefits: in addition to lowering blood glucose, may help with weight loss
Possible side effects: nausea (which may get better or go away with time), hypoglycemia, and, in rare cases, acute pancreatitis, a dangerous inflammation of the pancreas. (A definite cause-and-effect relationship with pancreatitis has not been established.)

Liraglutide (Victoza)
Status: available by prescription
Dosing: injected once daily with or without food
Benefits: similar to those of exenatide, but with perhaps better blood glucose control
Possible side effects: similar to exenatide's, though potentially less severe

Exenatide-LAR
Status: in clinical trials
Dosing: injected once weekly with or without food
Benefits: blood glucose control, weight loss
Possible side effects: similar to exenatide's, though potentially less severe

DPP-4 Inhibitors

Sitagliptin (Januvia)
Status: available by prescription
Dosing: taken orally once a day with or without food
Benefits: lowers A1C, well tolerated, rarely causes hypoglycemia
Possible side effects: allergic reactions, including skin rash (rare)

Saxagliptin (Onglyza)
Status: available by prescription; however, the FDA is requiring a post-market study to ensure that saxagliptin doesn't increase cardiovascular risks in older and sicker people
Dosing: taken orally once a day with or without food
Benefits: Lowers A1C, well tolerated, rarely causes hypoglycemia
Possible side effects: headache, urinary tract infections, and allergic reactions, including skin rash (rare)

Alogliptin
Status: application submitted to the FDA in January 2008 but withdrawn in June 2009 to meet new FDA requirements for long-term studies on cardiovascular risk
Dosing: taken orally once a day
Benefits: lowers A1C, well tolerated, rarely causes hypoglycemia
Possible side effects: not yet available, but may be similar to those of other DPP-4 inhibitors

 
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